Browsing by Author "Expert, Paul"

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Consolidating healthcare Sandbox in KSA: benchmarking against successful global regulatory sandbox using systems thinking framework
(University College London, 2024-08-28) Alrowili, Balges; Expert, Paul
Aim: This review was intended to provide insights on how the Ministry of Health in KSA can best utilise and expand on regulatory sandboxes for healthcare improvement through partnerships, integration, effective supervision, efficient data gathering and funding. Theoretical Framework: The systems thinking perspective was used to identify the complexity and how elements in the regulatory sandbox are related. Methodology: The present study used a scoping review methodology to identify the available literature on Saudi sandboxes without making an evaluation of the quality of the studies or their risk of bias. To narrow articles, inclusion criteria were restricted to articles published in English from 2016, which yielded a total of 5 studies. Findings: Research established that sandboxes are used mostly in the financial industry but could be useful in the healthcare sector to allow for experimentation of products under legal standards. Nonetheless, questions are raised regarding the development of regulations, limitation of information, data secrecy, involving stakeholders, and sustainability after the sandbox phase. Some of these issues include an increase in inequality, Safety and efficacy data, and applicability to LMICs needs more studies. Recommendations: There is more risk when sandboxing intersectoral to require more precaution to protect the public interest. This means that regulators need to step in and close gaps in the regulation of digital health technologies to ensure that safety and effectiveness are set. Subsequent research must explore if sandboxes meet their purpose and if they are portable. Approval regulations are other facets that should be considered which include regulator discretion, process and/or outcomes orientation, stakeholder participation, and post-sandbox regulation.
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DESIGNING A CLINICAL TRIALS FRAMEWORK FOR WEARABLE TECHNOLOGIES AT SEHA VIRTUAL HOSPITAL IN SAUDI ARABIA
(UCL, 2024) Madkhali, Marwan; Expert, Paul
The purpose of this research is to design a clinical trials framework for wearable technologies at Seha Virtual Hospital (SVH) in Saudi Arabia. The framework aims to evaluate the usability, effectiveness, and impact of wearable technologies on patient outcomes in a virtual care setting, aligning with the national strategy for digital health transformation. The research also seeks to establish benchmarks and generate high-quality evidence on the efficacy of these technologies for digital health in Saudi Arabia. The SVH, as a pioneering digital health centre, recognises the potential of wearable technologies to revolutionise healthcare by enabling remote monitoring and real-time data collection. The proposed framework will facilitate the integration of these technologies into clinical trials, contributing to evidence-based practices and improved patient care. The research methodology involved a systematic literature review to identify key themes and challenges in integrating wearable technologies into clinical trials. The review adhered to the PRISMA guidelines and included studies published between 2014 and 2024 that examined the use of wearable technologies in clinical trials for virtual healthcare delivery. Thematic analysis was employed to identify key themes and challenges. The findings highlighted the importance of usability and positive user experience, seamless data integration and high data quality, patient-centric design to promote adherence, the value of real-world evidence and feasibility studies, addressing regulatory and ethical considerations, and ensuring successful technology integration. The research also identified key benchmarks from existing clinical trials in different countries, including usability and patient-centred design, real-world data integration, methodological rigour and validation, ethical and regulatory compliance, personalised treatment plans and data accuracy, and hybrid models and flexibility. Results the comprehensive clinical trials framework was proposed. The framework incorporates needs assessment, technical performance evaluation, usability testing, feasibility assessment, and outcome measurement. It also emphasises ethical considerations, regulatory compliance, and data security. The implementation of this framework at SVH will enable the effective evaluation of wearable technologies, leading to improved patient monitoring, enhanced virtual care delivery, and ultimately, better patient outcomes. Keywords: clinical trials, wearable technologies, virtual healthcare, usability, and framework.
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Enhancing Efficiency in Cataract Surgery: A Lean Management Approach at Øjenlægernes Center
(Saudi Digital Library, 2023-09-01) Altamimi, Saud; Expert, Paul; Hammett, Simon; Expert, Paul
The Øjenlægernes Center, specializing in cataract surgeries, efficiently conducts about 28 operations daily. However, there's potential to further improve patient flow, satisfaction, and efficiency. This research explores the surgery process, identifying areas for enhancement via lean management principles. Lean management, aimed at reducing waste without compromising productivity, has gained traction in healthcare. The study highlights opportunities in patient referral, appointment scheduling, waiting times, optometrist exams, consent form processes, and inventory management. Insights are drawn from success stories like the Wilmer Eye Institute and Hospital for Sick Children's eye clinic, which benefitted from lean's application. However, adopting lean in healthcare has its challenges, including resistance to change. A well-structured plan is crucial. The Aravind Eye Care System's success provides valuable lessons, emphasizing strategic operational changes. Recommendations for Øjenlægernes Center include a digital appointment system, optimizing optometrist exams, e-Consent forms, better inventory management, and reduced waiting times. Engaging all staff in the lean transformation process is crucial for success. In summary, though Øjenlægernes Center is operationally efficient, leveraging lean management can elevate its performance and patient satisfaction. Future studies should assess the long-term effects of these changes and their applicability in similar institutions. The research underscores lean management's potential in revolutionizing healthcare operations.
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Mapping the patient journey in breast cancer screening in Saudi Arabia
(Saudi Digital Library, 2023-12-01) Saeedy, Ghudir; Expert, Paul
Purpose: The rapid surge in breast cancer incidence among Saudi females triggered a robust governmental response since 2015 (Saudi Arabia. MOH, 2020d, Saudi Arabia. MOH, 2015). This initiative prioritizes health promotion and prevention, with the Health Holding Company aiding in implementing the breast cancer screening (BCS) pathway to encourage early screening and deliver efficient healthcare. Patient experience significantly impacts the BCS pathway's success, playing a pivotal role in achieving desired outcomes. However, the exploration of patient experience in the Saudi Arabian BCS pathway remains unexplored. This report employs Patient Journey Mapping (PJM) through operations management to underscore this significance. Methodology: This study employs a narrative literature review methodology to explore the primary touchpoints, key concepts, and pain points of the patient experience in Saudi Arabia's BCS pathway. These concepts are identified through the PJM framework, and recommendations to enhance the experience are provided. Findings: The study identifies twelve patient journey concepts. At the PHC level: (1,2) women’s awareness and psychology, (3) GP’s role, (4) first impression, (5) embarking mammography, (6) medical staff as guardians. At the secondary care level: (7) care coordination, (8) effective communication, (9) practitioner-patient rapport. At the tertiary care level: (10) decision-making, (11) circle of support, (12) beyond treatment. To enhance these concepts, the KSA health system should expand mass media awareness, alleviate mammography discomfort, bolster care coordination, implement closed-loop communication, and embrace women's empowerment and support. Value: Drawing on the PJM framework, this study identifies key concepts governing the BC patient experience within the BCS pathway and provides strategies to enhance them. The Saudi MOH can promote preventive care, reduce the BC mortality rate, and more by embracing these milestones. Moreover, The findings inform quality improvement efforts, operational strategies, and fostering a patient-centric healthcare ecosystem. These strategies could serve as a foundation for an audit tool to gauge service alignment with patient needs and inform other care pathways in KSA.
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